OB - Chapter 6: Nursing Management During Pregnancy
After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, which statement indicates the need for additional teaching? a) "I'll switch to chewing gum instead of using mints." b) "I'll increase my time spent on walking each day." c) "I'll try to drink more fluids to help move things along." d) "I'll stay away from foods like cabbage and brussels sprouts."
"I'll switch to chewing gum instead of using mints."
A woman in her first trimester is having trouble maintaining adequate nutrition because of nausea and vomiting. She also complains that her heartburn gets worse after eating so she avoids food even when she feels hungry. To help with her nutritional deficit, she is taking a multivitamin supplement. Which substance do you caution her to avoid within 1 hour of ingesting her multivitamin supplement? a) Acetaminophen b) Fatty or fried foods c) Coffee or other caffeinated beverages d) An antacid
An antacid
A client wants to know if she can engage in intercourse during pregnancy. Which of the following should the nurse confirm to ensure that sexual intercourse or orgasm is not contraindicated in the client? Select all that apply. a) Client does not have dependent edema b) Client does not face a risk of threatened abortion c) Client is not at risk for pre-term labor d) Client does not have breast tenderness e) Client has experienced quickening
• Client does not face a risk of threatened abortion • Client is not at risk for pre-term labor
Yvonne, a 27-year-old client, is in the first trimester of an unplanned pregnancy. She acknowledges that it would be best if she were to quit smoking now that she is pregnant, but states that it would be too difficult given her 13 pack-year history and circle of friends who also smoke. She asks the nurse, "Why exactly is it so important for me to quit? I know lots of smokers who have happy, healthy babies." What can the nurse tell Yvonne about the potential effects of smoking in pregnancy? a) "Smoking during pregnancy places your baby at an increased risk of mental retardation." b) "Smoking is unhealthy for anyone's heart, but your baby faces an especially high risk of heart trouble if you smoke while you're pregnant." c) "Babies of women who smoke tend to weigh significantly less than other infants." d) "Smoking during pregnancy means that your child will be born with a dependence on nicotine and will have to endure a period of withdrawal in his or her first days of life."
"Babies of women who smoke tend to weigh significantly less than other infants."
A woman in her sixth month of pregnancy comes in for her first prenatal examination. She complains today of headache and abdominal pain of several months' duration. She appears somewhat hurried or nervous. What questions would the nurse ask next? a) "Do you feel safe at home?" b) "Have you been eating properly and taking a prenatal vitamin?" c) "Do you have a family history of thyroid disease?" d) "How much activity have you been able to fit into your schedule?"
"Do you feel safe at home?"
In light of the high incidence of some illnesses in women, which of the following questions is most important to include in a review of systems for a pregnant woman? a) "Have you had any neurologic diseases?" b) "Have you had any urinary tract infections?" c) "Have you ever had a heart attack?" d) "Do you have a peptic ulcer?"
"Have you had any urinary tract infections?"
A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during her pregnancy. Which of the following patient statements alerts the nurse to the need for further teaching? a) "I will avoid having intercourse following the rupture of the membranes." b) "If I experience bleeding, I will abstain from vaginal intercourse." c) "I should substitute intercourse with nonsexual touch to avoid harming the fetus." d) "I will experience a heightened need for touch throughout my pregnancy."
"I should substitute intercourse with nonsexual touch to avoid harming the fetus."
A pregnant woman has developed varicosities. Which of the following statements would suggest she needs additional health teaching? a) "I maintain a high fluid intake." b) "I'll try not to stand for long periods." c) "I wear knee-highs rather than pantyhose." d) "I dorsiflex my feet and ankles frequently."
"I wear knee-highs rather than pantyhose."
After teaching a pregnant woman how to count fetal movements, the nurse determines that the teaching was successful when the client states which of the following? a) "I'll do the count once a week on a morning that I'm not rushed for work." b) "I'll sit comfortably in a recliner or lie on my side when I do the counts." c) "I'll do the counts while I'm sitting and watching my son's basketball game." d) "I won't expect more than three movements to happen in an hour."
"I'll sit comfortably in a recliner or lie on my side when I do the counts."
A nurse you know is 5 weeks pregnant. She works on a unit where chemotherapy is administered. Which of the following statements would make you believe she needs additional health teaching about avoiding teratogens during pregnancy? a) "I never accompany clients to the x-ray department." b) "I care for about five clients a day." c) "Latex gloves irritate my hands, so I don't use them." d) "I find giving emotional support taxing."
"Latex gloves irritate my hands, so I don't use them."
A client who is 32 weeks gestation tells the nurse that she has been experiencing shortness of breath when walking up the steps at home. She is concerned that something is wrong. What is the nurse's best response? a) "Oxygen requirements are increasing in your body because the fetus is growing" b) "The enlarging uterus pushes against your diaphragm and this makes breathing shallow" c) "You only have a few more weeks until you deliver and then you will breathe fine again" d) "Don't worry about this because it is a normal change that occurs with pregnancy"
"The enlarging uterus pushes against your diaphragm and this makes breathing shallow"
A client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse? a) "The safest medication to take for your headaches during your pregnancy would be Ibuprofen." b) "Wait until you reach your third trimester. You can take something to relieve headaches then." c) "The safest medication to take for your headaches during your pregnancy would be acetaminophen (Tylenol)." d) "You don't want to harm the baby by taking medications now, do you?"
"The safest medication to take for your headaches during your pregnancy would be acetaminophen (Tylenol)."
A student nurse asks the instructor what percentage of clinically recognized pregnancies end in miscarriages during the first trimester. The most accurate response from the registered nurse is which of the following? a) 31% to 40% b) 11% to 20% c) 21% to 30% d) 5% to 10%
11% to 20%
The first time you see a woman during pregnancy, her fundal height is palpable at the level of her umbilicus. This measurement is typical of what gestational age? a) 6 weeks b) 24 weeks c) 12 weeks d) 20 weeks
20 weeks
A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a miscarriage at 12 weeks and gave birth to a son, now 3 years old, at 32 weeks. Using the GTPAL system, the nurse would document this woman's obstetric history as: a) 20111 b) 21212 c) 30111 d) 31021
30111
A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every: a) 4 weeks b) 1 week c) 3 weeks d) 2 weeks
4 weeks
Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She delivered one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. a) 3, 2, 1, 1, 1 b) 4, 1, 1, 1, 1 c) 4, 2, 2, 1, 1 d) 3, 2, 1, 2, 1
4, 1, 1, 1, 1
What advice should the nurse provide to a pregnant patient who admits to continuing to drink alcohol 1 to 2 times a week? a) The affects of alcohol on the fetus are not fully understood b) She should avoid alcohol in the first trimester c) She may have an occasional drink after the first trimester d) Alcohol should not be consumed during pregnancy
Alcohol should not be consumed during pregnancy
A client in the third trimester of pregnancy has to travel a long distance by car. The client is anxious about the effect the travel may have on her pregnancy. Which of the following instructions should the nurse provide to promote easy and safe travel for the client? a) Use a lap belt that crosses over the uterus. b) Activate the air bag in the car. c) Apply a padded shoulder strap properly. d) Always wear a three-point seat belt.
Always wear a three-point seat belt.
The nurse should administer Rhogam (Rh immune globulin) to the pregnant woman who is Rho(D)-, after which of the following tests? a) CST (Contraction Stress Test) b) Biophysical Profile c) Amniocentesis d) NST (Non Stress Test)
Amniocentesis
When measuring the diagonal conjugate of a woman's pelvis, the distance between which of the following anatomic landmarks would be used? a) Anterior surface of the sacral prominence and the anterior surface of the symphysis pubis b) Medial surface of the ischial tuberosities c) Posterior surface of sacrum and the axis of the ischial tuberosities d) Interior surface of the sacral prominence and the posterior surface of the symphysis pubis
Anterior surface of the sacral prominence and the anterior surface of the symphysis pubis
Mrs. Smith asks you to compute her expected date of birth. Based on the fact that her last menstrual flow began on July 20, her date would be a) May 20. b) April 27. c) March 13. d) April 13.
April 27.
The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation? a) At the level of the umbilicus b) At the level of the symphysis pubis c) Three finger-breadths above the umbilicus d) At the level near the bottom of the sternum
At the level of the umbilicus
A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which of the following locations? a) At the umbilicus b) Between the symphysis and umbilicus c) Symphysis pubis d) Just below the ensiform cartilage
At the umbilicus
What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances? a) Maintain personal hygiene b) Avoid intake of coffee c) Eat a well-balanced diet d) Avoid medications
Avoid medications
A woman in her third trimester complains to the nurse of significant back pain. The nurse questions the client carefully and records a detailed account of her back symptoms. What is the best rationale for the nurse evaluating the client's back symptoms with such care? a) Back pain could be a sign of bladder or kidney infection b) Back pain could be a result of a soft mattress c) Back pain could be a result of improper lifting d) Back pain could be a sign of degenerated discs
Back pain could be a sign of bladder or kidney infection
Which of the following nursing interventions is appropriate when preparing a woman for an amniocentesis? a) Suggest that she take a deep breath and hold it during needle insertion b) Inform her that a narcotic premedication will be given to prevent pain during needle insertion c) Be certain she knows that there is are risks of complication, such as premature labor, from amniocentesis d) Instruct her not to empty her bladder prior to the procedure
Be certain she knows that there is are risks of complication, such as premature labor, from amniocentesis
Which of the following statements is true regarding sexual activity and pregnancy? a) Because of pelvic congestion, women may experience increased clitoral sensitivity. b) Intercourse is not recommended before 36 weeks because it can induce labor. c) Women who have a partially dilated or effaced cervix at term must refrain from sexual activity. d) Female orgasm on the EDC will cause labor to begin.
Because of pelvic congestion, women may experience increased clitoral sensitivity.
Gestational diabetes occurs around the 24th week of gestation. When should every woman be screened for gestational diabetes? a) Between 20 and 24 weeks' gestation b) Between 24 and 28 weeks' gestation c) Between 28 and 32 weeks' gestation d) Between 16 and 20 weeks' gestation
Between 24 and 28 weeks' gestation
During the physical exam at the first prenatal visit a speculum exam is performed. What sign of pregnancy does the practitioner look for during the speculum exam? a) Hagar's sign b) Chadwick's sign c) Goodell's sign d) Nagel's sign
Chadwick's sign
Ramona Silver, age 38, has one child with Tay-Sachs disease. She and her partner both carry the Tay-Sachs gene and did not intend to have more children, but she has just discovered that she is pregnant. She plans to have an abortion if tests show that the fetus has the Tay-Sachs gene. Which test will the primary care provider likely order? a) A multiple marker screening test b) Amniocentesis c) Chorionic villus sampling d) Percutaneous umbilical blood sampling
Chorionic villus sampling
A pregnant client wishes to know if sexual intercourse would be safe during her pregnancy. Which of the following should the nurse confirm before educating the client regarding sexual behavior during pregnancy? a) Client does not have anemia. b) Client does not experience facial and hand edema. c) Client does not have an incompetent cervix. d) Client does not have anxieties and worries.
Client does not have an incompetent cervix.
A woman has come to the clinic for her first prenatal visit. Which of the following would be the most effective way to initiate data gathering for a health history? a) Wait until she is in the examining room and prepared for her physical examination. b) Conduct an interview in a private room to obtain her health history. c) Ask her some basic questions in the waiting room before taking her to the examining room. d) Ask her to complete a written questionnaire concerning her past and present status.
Conduct an interview in a private room to obtain her health history.
A pregnant client with multiple gestation arrives at the maternity clinic for a regular antenatal check up. The nurse would be aware of the client's risk of perinatal complications including which of the following? a) Post-term birth b) Congenital anomalies c) Maternal hypotension d) Fetal non-immune hydrops
Congenital anomalies
A woman in early pregnancy is concerned because she is nauseated every morning. Which of the following would be the best measure to help relieve this? a) Take a teaspoon of baking soda before breakfast. b) Delay breakfast until midmorning. c) Take two aspirin on arising. d) Delay toothbrushing until noon.
Delay breakfast until midmorning.
The nurse discovers a soft systolic murmur when auscultating the heart of a client at 32 weeks' gestation. Which action would be most appropriate? a) Ask another nurse to assess the heart. b) Refer her for cardiac catheterization. c) Document this and continue to follow at future visits. d) Inquire if the client has chest pain.
Document this and continue to follow at future visits.
Which of the following findings from a woman's initial prenatal assessment would be considered a possible complication of pregnancy that requires reporting to a physician for management? a) Increased lumbar curvature b) Nasal congestion and swollen nasal membranes c) Episodes of double vision d) Palpitations when lying on her back
Episodes of double vision
The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which of the following danger sign might occur at this point in her pregnancy? a) Excessive vomiting b) Swelling of extremities c) Dyspnea d) Lower abdominal pressure
Excessive vomiting
Which of the following findings is most worrisome in Melissa, a woman in her 26th week of pregnancy? a) Generalized hair loss b) Facial edema c) Nosebleeds d) A hyperpigmented rash over the maxillary region bilaterally
Facial edema
When providing preconception care to a client, which medication would the nurse identify as being safe to continue during pregnancy? a) Accutane b) Lithium c) Famotidine d) Warfarin
Famotidine
A woman relates to the nurse that she understands that dietary fat is bad for her and that she should avoid it during pregnancy. How should the nurse respond? a) Fats are not essential during pregnancy and thus are optional b) Fats are essential during pregnancy, and fish such as marlin and orange roughy are good sources c) Fats are essential during pregnancy, and vegetable oils are a good source d) Fats should be avoided during pregnancy
Fats are essential during pregnancy, and vegetable oils are a good source
Mary Jones's maternal serum alpha-fetoprotein (MSAFP) screening results show that her MSAFP levels are high. What is the best response by the nurse? a) Her child is at risk for neural tube defects b) Her child is at risk for Down syndrome c) Further test are required based on the results d) The test may have been run during the wrong weeks gestation
Further test are required based on the results
Martha is pregnant and arrives for her second prenatal appointment. Her previous pregnancy ended at 19 weeks and she has 3-year-old twins born at 30 weeks gestation. How will you document her "G" and "L" for her records? a) G2 L2 b) G3 L2 c) G3 L0 d) G2 L0
G3 L2
A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history? a) G2 P0020 b) G3 P0021 c) G3 P0020 d) G2 P1020
G3 P0020 Gravida (G) is the total number of pregnancies she has had, including the present one. Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: F = Full term: number of babies born at 37 or more weeks of gestation, which is 0 and not 1 in this case. P = Preterm: number of babies born between 20 and 37 weeks of gestation, which is 0 in this case. A = Abortions: total number of spontaneous and elective abortions, which is 2 in this case. L = Living children, as of today.
A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the patient chart? a) G4 P3115 b) G5 P3114 c) G5 P3115 d) G5 P1135
G5 P3114
A woman presents to the clinic in the first trimester of pregnancy. She has three children living at home. One of them was born prematurely at 34 weeks. The other two were full-term at birth. She has a history of one miscarriage. How do you record her obstetric history on the chart using the GTPAL format? a) G4 T3 P0 A1 L3 b) G3 T2 P1 A1 L3 c) G4 T2 P1 A1 L3 d) G5 T2 P1 A1 L3
G5 T2 P1 A1 L3
A nurse explains to a pregnant woman the importance of consuming adequate iodine in her diet. Which of the following conditions can a deficiency in iodine lead to? a) Diminished bone density b) Hypercholesterolemia c) Goiter d) Anemia
Goiter
How would the obstetric history be recorded for a pregnant woman if she has previously delivered two infants at term and had one abortion at 12 weeks' gestation? a) Gravida 3, para 3 b) Gravida 4, para 2 c) Gravida 4, para 3 d) Gravida 3, para 2
Gravida 4, para 2
A woman who is 4 months pregnant notices frequent heart palpitations and leg cramps. She is anxious to learn how to alleviate these. Which of the following nursing diagnoses would best apply to her? a) Risk for ineffective breathing pattern related to pressure of the growing uterus b) Impaired urinary elimination related to inability to excrete creatine from her muscles c) Pain related to severe complications of pregnancy d) Health-seeking behaviors related to ways to relieve discomforts of pregnancy
Health-seeking behaviors related to ways to relieve discomforts of pregnancy
A young woman in her first trimester confesses to the nurse when questioned that she is probably not consuming enough calories. The nurse should explain to this client that deficient nutrition can hinder the baby's growth, which at this point in her pregnancy is primarily via an increase in the number of cells formed. This type of growth is known as which of the following? a) Hypertrophy b) Hyperemesis gravidarum c) Hypercholesterolemia d) Hyperplasia
Hyperplasia
The nurse teaches the pregnant client how to perform Kegel exercises as a way to accomplish which of the following? a. Prevent perineal lacerations b. Stimulate labor contractions c. Increase pelvic muscle tone d. Lose pregnancy weight quickly
Increase pelvic muscle tone
If constipation is a problem for a woman during pregnancy, which of the following would be best to recommend? a) Eating more meat products b) Mineral oil c) Increased fiber intake d) Stopping prenatal vitamins temporarily
Increased fiber intake
Leah is 28 weeks pregnant. In preparing for discomforts that occur during the final trimester of pregnancy, you would teach her about? a) Good oral hygiene to decrease ptyalism b) Eating a well-balanced diet to prevent anemia c) Increased shortness of breath and dyspnea before lightening d) Avoid exercise to prevent varicosities
Increased shortness of breath and dyspnea before lightening
Which of the following nursing interventions should the nurse perform when assessing fetal well-being through abdominal ultrasonography in a client? a) Instruct the client to refrain from emptying her bladder. b) Inform the client that she may feel hot initially. c) Instruct the client to report the occurrence of fever. d) Obtain and record vital signs of the client.
Instruct the client to refrain from emptying her bladder.
Why is a Papanicolaou smear done at the first prenatal visit? a) It identifies abnormal cervical cells. b) It predicts whether cervical cancer will occur. c) It detects if uterine cancer is present. d) It helps to date the pregnancy.
It identifies abnormal cervical cells.
You advise your pregnant patient to keep a small high-carbohydrate snack on the bedside table. This advice is given to ameliorate which condition? a) Faintness b) Slowed GI transit time c) Nausea and vomiting d) Heartburn
Nausea and vomiting
When discussing rest and sleep with a pregnant woman, which of the following positions would you suggest that she use for napping? a) On her back with a pillow under her knees and hips b) On her side with the weight of the uterus on the bed c) On her back with a pillow under her head d) On her stomach with a pillow under her breasts
On her side with the weight of the uterus on the bed
Based on the incidence of disease in woman, which assessment of lower extremities would be most important to make in a pregnant woman? a) Diameter of the calf muscle b) Lateral movement of the kneecap c) Presence of varicosities d) Blanching and refilling of toenails
Presence of varicosities
A woman accustomed to daily exercise complains late in her second trimester of pregnancy that she is experiencing "terrible" heartburn at night. What would you advise her to do? a) Seek emergency medical care. b) Take sodium bicarbonate. c) Put 6-inch blocks under the head of her bed. d) Stop or severely curtail her exercise.
Put 6-inch blocks under the head of her bed.
A nurse is instructing a pregnant woman about monitoring fetal movements and informs her that normally the fetus will have the same amount every day. The nurse adds that if the patient notices an unusual increase of decrease, this is a sign of which of the following? a) Response to a need for oxygen b) Fetal shifting of activity-sleep balance c) Fetal heartburn d) Cramping in the uterus and trying to get comfortable
Response to a need for oxygen
As part of a 31-year-old client's prenatal care, the nurse is assessing immunization history. Which of the following immunizations is most relevant to ensuring a healthy fetus? a) Diphtheria, tetanus, and pertussis b) Rubella c) Hepatitis A and B d) Measles
Rubella
The pregnant patient is asking about medications, supplements, and vaccines. Which of the following would the nurse indicate as potentially teratogenic? a) Penicillin b) Folic Acid c) Tylenol d) Rubella vaccine
Rubella vaccine
A client in her third trimester of pregnancy wishes to use the method of feeding formula to her baby? a) Mix one scoop of powder with an ounce of water. b) Refrigerate any leftover formula. c) Feed the infant every 8 hours. d) Serve the formula at room temperature.
Serve the formula at room temperature.
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy? a) Premature ventricular contractions b) Split S1S2 c) S4 (atrial gallop) d) Soft systolic murmur
Soft systolic murmur
A pregnant woman is planning on taking a vacation that involves extensive travel by automobile. Which of the following guidelines should you give her? a) Sit in the back seat with feet elevated b) Travel no more than 120 miles daily c) Stop and walk every few hours d) Limit trips away from home, great than 200 miles
Stop and walk every few hours
A non-stress test is performed on a pregnant woman. The nurse informs the client the test was reactive. Which of the following statements by the patient indicates understanding of the test results? a) The test is non-reactive, which is reassuring b) The results indicate a contraction stress test is needed for evaluation c) The fetal heart rate increases with activity and indicates fetal well-being d) There is no evidence of congenital anomalies or deformities
The fetal heart rate increases with activity and indicates fetal well-being
When describing the role of a doula to a group of pregnant women, which of the following would the nurse include? a) The doula is a professionally trained nurse hired to provide physical and emotional support. b) The doula primarily focuses on providing continuous labor support. c) The doula can perform any necessary clinical procedures. d) The doula is capable of handling high-risk births and emergencies.
The doula primarily focuses on providing continuous labor support.
Body joints become more relaxed with pregnancy because of relaxin, a hormone produce by the placenta. a) False b) True
True
Green tea should be avoided during pregnancy. a) True b) False
True
There is a strong correlation between poor oral health and preterm birth. a) True b) False
True
A pregnant woman states that she would like to take a tub bath but has heard from her aunt that this could be dangerous to the baby. Which of the following instructions should the nurse give to the patient? a) Avoid tub baths at all times during pregnancy, as they may be dangerous for the fetus b) Tub baths are fine, but avoid using soap, as this may prove a teratogen to the fetus c) Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding d) Long soaks in very hot water are encouraged during pregnancy to promote relaxation
Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding
A client in her third trimester complains to the nurse of shortness of breath when sleeping. The nurse informs the client that this is normal and occurs because the growing fetus puts pressure on the diaphragm. Which measure should the nurse suggest to help alleviate this problem? a) Use extra pillows b) Lie on a firmer mattress c) Avoid overeating d) Avoid spicy food
Use extra pillows
A nurse is caring for a pregnant client in her second trimester of pregnancy. The nurse educates the client to look for which of the following danger signs of pregnancy needing immediate attention by the physician. a) Vaginal bleeding b) Painful urination c) Severe, persistent vomiting d) Lower abdominal and shoulder pain
Vaginal bleeding
One function of the nurse when dealing with a pregnant client is to teach self-care during pregnancy. One of the topics that the nurse provides teaching about is breast care. What does the nurse teach the client about keeping the breasts clean? a) Use a mild soap and cool water to keep the nipples clean b) Wash the nipples with clean water only c) Wash the nipples with a deodorant soap to keep them clean and help toughen them d) Use hot water and a mild soap to keep the nipples clean
Wash the nipples with clean water only
During a clinic visit, a pregnant client at 30 weeks' gestation tells the nurse, "I've had some mild cramps that are pretty irregular. What does this mean?" The cramps are probably: a. The beginning of labor in the very early stages b. An ominous finding indicating that the client is about to have a miscarriage c. Related to overhydration of the woman d. Braxton Hicks contractions, which occur throughout pregnancy
Braxton Hicks contractions, which occur throughout pregnancy
A woman who is 3 months pregnant enjoys a slow, long walk daily. Which of the following would be most appropriate for her concerning this for the remainder of her pregnancy? a) Engage in aerobics for greater benefits. b) Stop and rest every block. c) Reduce walking to half a block daily. d) Continue this as long as she enjoys it.
Continue this as long as she enjoys it.
A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which of the following symptoms is an indicator of true labor? a) Increase in fetal kick count b) Lightening (descent of the fetus into the pelvis) c) Intermittent backache stronger than usual d) Contractions beginning in the back and sweeping forward across the abdomen
Contractions beginning in the back and sweeping forward across the abdomen
A patient in the OB clinic is complaining of being awakened by leg cramps while sleeping. Select the appropriate nursing intervention. a) Use plantar flexion exercises 3 times every day b) Dorsiflex the foot while extending her leg during the cramp c) Avoid any supplementation of vitamins or minerals d) Encourage her to drink more fluids, 10 glasses a day
Dorsiflex the foot while extending her leg during the cramp
Some women contract with other women to provide support during pregnancy and delivery, to provide emotional support during labor and delivery, and to aid in establishing breastfeeding. What is the name of the woman who is contracted? a) Midwife b) Doula c) Partera d) Pregnancy aide
Doula
A common complaint during pregnancy is heartburn. As the clinic nurse, what would you recommend to decrease the discomfort of heartburn? a) Eat easily digested carbohydrates b) Eat small, frequent meals c) Drink liquids immediately before meals d) Drink warm liquids with your meals
Eat small, frequent meals
If constipation is a problem for a woman during pregnancy, which of the following measures would be best to recommend? a) Reducing her iron supplement b) Mineral oil c) Increasing intake of meat in her diet to provide fiber d) Increasing fluid intake
Increasing fluid intake
A 28-year-old client who has just conceived arrives at a health care facility for her first prenatal visit to undergo a physical examination. Which of the following interventions should the nurse perform to prepare the client for the physical examination? a) Instruct the client to empty her bladder. b) Ensure that the client's family is present. c) Ensure that the client is lying down. d) Instruct the client to keep taking deep breaths.
Instruct the client to empty her bladder.
A client in her second trimester of pregnancy visits a healthcare facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which of the following precautions should the nurse instruct the pregnant client to take when practicing aerobic exercises? a) Wear support hose when exercising b) Maintain tolerable intensity of exercise c) Reduce the amount of exercise d) Begin a new exercise regimen
Maintain tolerable intensity of exercise
A nurse counsels a pregnant woman regarding her recommended daily allowance of calories. She advises her to obtain her carbohydrate calories from complex carbohydrates rather than simple carbohydrates. What is the best rationale for this guidance? a) Faster digestion of complex than simple carbohydrates b) Provision of a greater amount of calories per gram c) More consistent regulation of glucose and insulin d) Greater fatty acid content
More consistent regulation of glucose and insulin
Which of the following biophysical profile findings indicate poor oxygenation to the fetus? a. Two pockets of amniotic fluid b. Well-flexed arms and legs c. Nonreactive fetal heart rate d. Fetal breathing movements noted
Nonreactive fetal heart rate
A pregnant woman comes in for a routine third-trimester exam, which included a pelvic exam. She calls several hours later, very worried, to report a small amount of bleeding. What should you tell her? a) That the bleeding, called Chadwick's sign, is a normal part of pregnancy b) That her cervical mucous plug may have been expelled c) To return right away d) Not to worry but to report any heavy increase in bleeding
Not to worry but to report any heavy increase in bleeding
What is the term that refers to a woman who has never been pregnant? a) Nulligravida b) Multigravida c) Gravida d) Parity
Nulligravida
The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which of the following is the recommended schedule for prenatal care? a) Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth. b) Once every 4 weeks for the first 28 weeks, then every 3 weeks until 36 weeks, and then every 2 weeks until the birth. c) Once every 3 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth. d) Once every 4 weeks for the first 36 weeks, then weekly until the birth.
Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth.
A client in her third trimester of pregnancy visits the healthcare center and asks why she is constipated. Which of the following would the nurse include as the most likely cause when responding to the client? a) Engorgement of veins by the weight of the uterus b) Relaxation of cardioesophageal sphincter c) Pressure of fetal head on the bladder d) Pressure on intestine by the growing fetus
Pressure on intestine by the growing fetus
The nurse is preparing her teaching plan for a woman who has just had her pregnancy confirmed. Which of the following should be included in it? Select all that apply. a. Prevent constipation by taking a daily laxative b. Balance your dietary intake by increasing your calories by 300 to 500 daily c. Continue your daily walking routine just as you did before this pregnancy d. Tetanus, measles, mumps, and rubella vaccines will be given to you now e. Avoid tub baths now that you are pregnant to prevent vaginal infections f. Sexual activity is permitted as long as your membranes are intact g. Increase your consumption of milk to meet your iron needs
Prevent constipation by taking a daily laxative Balance your dietary intake by increasing your calories by 300 to 500 daily Continue your daily walking routine just as you did before this pregnancy Avoid tub baths now that you are pregnant to prevent vaginal infections Sexual activity is permitted as long as your membranes are intact Increase your consumption of milk to meet your iron needs
A nurse is caring for a client in her second trimester of pregnancy. During a regular follow-up visit, the client complains of varicosities of the legs. Which of the following instructions should the nurse provide to help the client alleviate varicosities of the legs? a) Avoid sitting in one position for long. b) Refrain from crossing legs when sitting for long periods. c) Refrain from wearing any kind of stockings. d) Apply heating pads on the extremities.
Refrain from crossing legs when sitting for long periods.
A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse most likely to give her? a) Take a hot water bath or shower daily to maintain hygiene. b) Apply lanolin ointment to the nipple and areola to prevent cracking. c) Do nipple exercises and stimulation on a regular basis. d) Rest on the left side for at least 1 hour in the morning and afternoon.
Rest on the left side for at least 1 hour in the morning and afternoon.
A 24-year-old pregnant woman complains of excessive vaginal discharge. The discharge is not associated with a strong odor, itching, or irritation but she finds it messy and unpleasant. What do you advise her to do? a) Use sanitary pads b) Decrease her fluid intake c) Douche and wash frequently with mild soap and warm, not hot, water d) See her primary care provider to be tested for STIs
Use sanitary pads
A woman in her first trimester shares with the nurse that she has been experiencing terrible nausea when she gets up in the morning. Which of the following should the nurse advise her to do? (Select all that apply.) a) Eat two regular meals later in the day b) Eat some saltine crackers before rising in the morning c) Delay breakfast until 10 or 11 AM d) Try eating soups or vegetable drinks in the morning e) Use a scopolamine patch f) Suck on sourball candies
• Eat some saltine crackers before rising in the morning • Suck on sourball candies • Delay breakfast until 10 or 11 AM • Try eating soups or vegetable drinks in the morning
A woman is concerned about the safety of continuing coitus with her partner during pregnancy. Which of the following should the nurse mention to her? (Select all that apply.) a) Avoid partner oral-female genital contact due to risk of air embolism b) Avoid coitus after your membranes have ruptured c) Coitus on the expected date of your period can initiate labor d) Coitus is generally not harmful to the fetus e) Have a non-monogamous sexual partner wear a condom f) Coitus can cause rupture of the membranes
• Avoid coitus after your membranes have ruptured • Coitus is generally not harmful to the fetus • Avoid partner oral-female genital contact due to risk of air embolism • Have a non-monogamous sexual partner wear a condom
Which of the following are purposes for prenatal care? (Select all that apply.) a) Determine the gestational age of the fetus. b) Identify women at risk for complications. c) Establish a baseline of present health. d) Monitor for fetal development and maternal well-being. e) Increase the business of the clinic. f) Maximize the risk of possible complications.
• Establish a baseline of present health. • Determine the gestational age of the fetus. • Monitor for fetal development and maternal well-being. • Identify women at risk for complications.
A fit 30-year-old woman in her first trimester would like to continue exercising during pregnancy. She says she normally jogs, but has been thinking about taking up cycling. She also would like to know how much exercise she should get. Which of the following instructions should the nurse give to the client? (Select all that apply.) a) Walking is an excellent exercise option during pregnancy b) Include warm-up and cool-down exercises c) Exercise three times weekly for 30 consecutive minutes d) Avoid sports that involve body contact e) Avoid exercises that involve movements of large muscle groups rhythmically f) Avoid taking up a new sport, such as cycling, during pregnancy
• Exercise three times weekly for 30 consecutive minutes • Include warm-up and cool-down exercises • Avoid sports that involve body contact • Avoid taking up a new sport, such as cycling, during pregnancy • Walking is an excellent exercise option during pregnancy
The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which of the following would the nurse include? Select all that apply. a) Headache with visual changes in the third trimester b) Nausea with vomiting during the first trimester c) Lower abdominal pain with shoulder pain in the first trimester d) Backache during the second trimester e) Sudden leakage of fluid during the second trimester f) Urinary frequency in the third trimester
• Headache with visual changes in the third trimester • Lower abdominal pain with shoulder pain in the first trimester • Sudden leakage of fluid during the second trimester
A client in her second trimester of pregnancy arrives at a health care facility complaining of heartburn. What instructions should the nurse offer to help the client deal with heartburn? Select all that apply. a) Sleep in a semi-Fowler's position b) Limit consumption of food before bedtime c) Avoid use of antacids d) Consume lots of liquids before bedtime e) Avoid overeating
• Sleep in a semi-Fowler's position • Limit consumption of food before bedtime • Avoid overeating
When preparing a class for a group of pregnant women about nicotine use during pregnancy, the nurse describes the major risks associated with nicotine use including: a) Increased risk of stillbirth b) Decreased birth weight in neonates c) Increased risk of placenta abruptio d) Increased risk of spontaneous abortion
Decreased birth weight in neonates
A pregnant client's last normal menstrual period was on August 10. Using Nagele's rule, the nurse calculates that her estimated date of birth (EDB) will be which of the following? a. June 23 b. July 10 c. July 30 d. May 17
May 17 using Nagele's rule, 3 months are subtracted and 7 days are added, plus 1 year from the date of the last menstrual period.
